I have been a trauma surgeon at a Level I trauma center for more than 28 years and have had many gratifying moments over those years witnessing thousands of patients return to happy and healthy lives following serious injury and illness. Yet, I have, on far too many occasions, had to tell a mother that her child would not be coming home ever again because of the lethal injuries he or she sustained from a firearm.

No one should have to experience the anguish of losing a child, whether due to homicide, suicide or accidental injury — especially when so many of these injuries can be prevented. Sadly, firearm-related deaths and injuries have increased dramatically since the pandemic, particularly among our youth.

The N.C. Child Fatality Task Force reports that the firearm death rates for children under 18 increased by 121% from 2019 through 2021. That’s why I’m greatly concerned by the repeal of North Carolina’s pistol purchase permitting system.

This system required a background check on all handgun sales, even if they were purchased from a private seller online or at a gun show. Sheriffs issued the permits and conducted a federal and state background check. Eliminating a background check at any point in the purchase of a firearm is dangerous for the public.

In states without regulations on private firearm sales, more people circumvent the federal background check system and purchase privately, avoiding a background check. In these states, 57% of firearms purchased from a private seller did not include a background check, compared to 26% in states regulating private firearm sales.

Studies have also found that state firearm licensing laws reduce the flow of guns trafficked within and between states and diverted for criminal misuse. Research also shows permitting systems like the N.C. pistol purchasing permit system saves lives.

We need only to look at Missouri, which repealed a similar law in 2007. In the following nine years, Missouri’s firearm homicide rate spiked 47%, compared to the rate expected without this law. Conversely, Connecticut’s firearm homicide rate has declined 28% in the 22 years since they enacted a permitting law similar to the one that North Carolina just repealed. The data is crystal clear: our permitting system saved lives.

Our hospitals and our communities are experiencing epidemic levels of gun violence. Instead of ending our permitting system and accepting the deadly and costly consequences that we know will follow, we urgently need to invest proactively in evidence-based violence prevention strategies that spare our communities unnecessary loss of life.

One such strategy is community-based violence intervention (CVI). These initiatives can take many forms, including street outreach programs, such as the Alternatives to Violence Program here in Charlotte (based upon the successful evidence-based Cure Violence Model) and hospital-based violence intervention programs like the ones being launched in Charlotte, Winston-Salem and in Wake County.

These hospital-based violence intervention programs have a long and well-established track record of saving lives, money and decreasing future engagement in violence in patients admitted to trauma centers with violence-related injuries.

Including $20 million in this year’s state budget for community violence intervention could fund a dozen or more CVI programs across the state. A $113 million investment over eight years in community violence intervention programs could potentially save a thousand lives across North Carolina and also save taxpayers $162 million in averted medical, police and criminal justice costs.

These evidence-based programs work. And they need appropriate funding to truly address the scope of our gun violence epidemic. I cannot overstate the importance of these programs in the midst of the current crisis, and I call on our leaders in Raleigh and in Washington to provide our communities with the support they need to combat this deadly disease.

As a surgeon, I am focused every single day on saving lives. I call on state and federal leaders to do the same by supporting background checks for all firearm purchases and funding impactful initiatives such as community violence intervention programs. The overall health of all our communities depends upon it.

Dr. David Jacobs is medical director of a Charlotte hospital-based Violence Intervention Program.